Individual
MISS WENDY LELIA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
59 BRADEEN ST, ROSLINDALE, MA 02131-1814
(617) 650-7053
Mailing address
59 BRADEEN ST, ROSLINDALE, MA 02131-1814
(617) 650-7053
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
62382
MA
Other
Enumeration date
02/13/2009
Last updated
02/13/2009
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